Chapter 10 - Somatic Symptom Disorders Flashcards Preview

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Flashcards in Chapter 10 - Somatic Symptom Disorders Deck (37):
1

What are the traditional psychophysiological disorders?

*Ulcers
*Asthma
*Headaches
*Hypertension
*Coronary heart disease

2

What are characteristics of ulcers?

*Strong relationship between ulcers and stress
*H-pylori bacteria, but also some people without bacteria get ulcers
*Genetic vulnerability - some people inherit a thin mucosal lining

3

What are characteristics of asthma?

*Constriction of airways --> wheezing
*Strong links with anxiety
*Not just because of medication

4

What are the two different types of headaches?

*Tension headaches - most common, appear to have heightened sensitivity to pain/stress (linked to proximal stressors)
*Migraine headaches - constriction/dilation of blood vessels (linked to distal stressors)

5

What are the characteristics of hypertension?

*Chronic high BP
*Most commonly diagnosed: essential hypertension
*Combo of physical factors along with stress and emotions
*Genetic vulnerability

6

Characteristics of coronary heart disease

*#1 cause of death - coronary artery blockage
*Temporary and partial --> angina - chest pain
*Complete blockage --> myocardial infarction

7

How does personality type factor into risk of coronary heart disease?

*Type A: competitive, hurried/impatient lifestyle, cynical hostility is "toxic" factor most strongly predicts CHD
*Type B: opposite of type A, more laid back, less likely to get CHD

8

What are the types of sleep disorder?

*Insomnia
*Hypersomnia
*Narcolepsy
*Sleep apnea

9

Subtypes of insomnia

*Primary (difficulty falling asleep)
*Maintenance (difficulty staying asleep)
*Termination (waking too early and can't go back to sleep)

10

What is hypersomnia?

Strong urge to sleep most of the day

11

What is narcolepsy?

Sudden episodes of sleep, excessive daytime sleepiness (EDS)

12

Characteristics of narcolepsy

*Cataplexy (sudden loss of muscle tone, 70% show, related to REM cycle?)
*Could be caused by deficiency of hypocretin (promotes wakefulness)
*May be autoimmune disorder
*May be genetic (dogs stronger link than humans)

13

Subtypes of sleep apnea

*Obstructive (most common, block airways)
*Central (lack of signals during sleep to breathe)

14

What are factitious disorders?

Reporting of symptoms that are voluntarily induced - main purpose is to get attention and care, they know nothing is wrong

15

What is Munchausen's syndrome?

Extreme factitious disorder - deliberately stimulates or fakes symptoms

16

What is Munchausen's by proxy syndrome?

Deliberately invoking or over-reporting symptoms in someone under their care to receive attention (legal issues - possible child abuse)

17

What is malingering?

Purposeful faking of symptoms - occurs for purpose of obtaining secondary gains

18

What are somatic symptom disorders?

Set of disorders characterized by physical problem with no apparent organic cause, or symptoms in excess of documented pathology (medically unexplained symptoms)
*KEY: patient honestly believes there is a physical cause

19

What are key factors in the biopsychosocial model of bodily preoccupation?

*Increased emotional arousal and associated symptoms
*Schema and attributions - maladaptive schemas
*Communication of bodily concerns to family members and responses - can either increase or decrease bodily symptoms

20

What is conversion disorder?

Reported loss of part or all of some basic body function (usually pseudo-neurological) that doesn't make anatomical sense

21

Onset of conversion disorder

Late childhood or early adolescence - often first occurs after some trauma or major stressor

22

Symptoms of conversion disorder

May be related to source of trauma or stress

23

Prevalence of conversion disorder

Higher rates in people of lower SES status, also people with less knowledge of medical concepts, more females

24

What is illness anxiety disorder?

Persistent belief that one has serious illness in spite of medical reassurance, lack of physical evidence, failure to fully develop illness

25

Onset and prevalence of illness anxiety disorder

*Early adulthood
*Males and females equal

26

What is somatization pattern?

Multiple recurrent bodily complaints - often presented in exaggerated fashion
*KEY: maladaptive thoughts, feelings, beliefs about symptoms

27

Diagnostic criteria of somatization pattern

*Disproportionate/persistent thoughts about physical symptoms
*High level of anxiety concerning symptoms
*Excessive time and energy devoted to these physical concerns

28

Onset of somatization pattern

Early adolescence

29

Prevalence of somatization pattern

*US: more females
*Greece & Puerto Rico: males higher than US (maybe cultural differences
*African Americans highest rates in the US

30

Course of somatization pattern

Chronic and yet fluctuates over time

31

What is the idiom of distress?

Physical symptoms provide a means by which they can express and/or communicate their psychic or emotional distress - they can't openly express their feelings and translate emotional pain into physical pain

32

What is somatic symptom disorder with predominant pain (pain disorder)?

Reports of extreme/incapacitating pain, either without identifiable physical signs, or that are in excess of what is expected based on knowledge of physical findings

33

What is onset of pain disorder?

Any age! (not for any other disorder)

34

Course of pain disorder with treatment

Most cases will resolve or become functional (it can be helpful to be functional again bc it could help with the pain)

35

What are signs of a poorer prognosis with pain disorder?

*Patients reporting multiple pain sites
*Patients reporting higher levels of depression

36

What mental disorders are comorbid with pain disorder?

*1/3 will meet criteria for clinical depression, far more than 1/3 show depressive symptoms
*Anxiety and anger also at higher levels

37

What is the default mode network research on pain disorder?

DMN is areas of brain that are active when body is at rest, but studies showed that the network did not quiet down when motor activity was being done in patients with pain disorder. Repeated firing of DMN can result in neuronal death