Chapter 6 - Dissociative and Somatic Symptoms Flashcards Preview

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Flashcards in Chapter 6 - Dissociative and Somatic Symptoms Deck (76):
1

What do dissociative disorders include?

a wide range of different symptoms that involve severe disruptions in consciousness, memory, and identity

2

What do somatic symptom disorders include?

long-standing beliefs that they have a serious illness, resulting in excessive anxiety and dysfunction

3

Hysteria

emotional excitability and physical symptoms such as convulsions, paralyses, numbness, loss of vision etc. - in the absence of any evident organic cause

4

What did Plato believe about hysteria? (Ancient Greece)

symptoms were caused in women by a wondering womb - believed womb was like an animal that desired to reproduce

5

Hysteria - Middle Ages

supernatural explanations - demonic possession and exorcism was usually the treatment

6

Pierre Janet

viewed breakdown in mental processes occurring as a result of exposure to traumatic experiences

7

Josef Breuer and Sigmund Freud

trauma (often as sexual nature) was a pre-disposing factor for hysteria and established a relationship between dissociation and hypnotic-like states

8

Conversion symptoms - Freud

expressions of unconscious psychological symptoms
ex. "conversion" of anxiety is more acceptable physical symptoms relieved the pressure of having to dealing directly with the conflict

9

primary gain

avoidance of conflict - primary reinforcement maintaining the somatic symptoms

10

secondary gain

benefits a patient may either unknowingly or knowingly seek by adopting a sick role

11

dissociative disorders

severe maladaptive disruptions or alterations of identity, memory, and consciousness that are experienced as being beyond one's control

12

dissociation

lack of normal integration of thoughts, feelings, and experiences in consciousness and memory

13

dissociative amnesia

inability to recall important personal information - no organic impairment

14

five patterns of memory loss

1) localized amnesia
2) selective amnesia
3) generalized amnesia
4) continuous amnesia
5) systematized amnesia

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localized amnesia

specific period of time is not recalled

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selective amnesia

certain aspects of the event are not recalled

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generalized amnesia

all information from the past is not recalled

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continuous amnesia

from specific time until present is not recalled

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systematized amnesia

certain types of information is not recalled

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which three patterns of memory loss are less common

generalized amnesia, continuous amnesia and systematized amnesia - commonly associated with diagnosis of dissociative identity disorder

21

what is a subtype of dissociative amnesia

dissociative fugue

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dissociative fugue

patient forgets their identity and may move away and assume a new identity - functioning is rarely impaired, linked to trauma

23

repressed memories

memories of traumatic events that a person forgets about/repress

24

depersonalization/derealization disorder

dissociation disorder in which the individual has persistent or recurrent experiences of depersonalization/derealization

25

depersonalization

sense of unreality and detachment from their own thoughts, feelings, sensations, actions, or body

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derealization

sense of unreality/detachment from surroundings - experience people or objects in their environment as unreal, dreamlike, foggy or distant

27

when is depersonalization/derealization disorder?

when severe depersonalization is the primary problem

28

dissociative identity disorder (DID)

patient has two or more distinct personality that regularly take control of the patient's behaviour

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alters

each subsequent personality

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host

one personality is considered this

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average number of personalities in DID

13-16

32

when does switching occur in DID

in stressful situations ex argument with spouse

33

age onset of DID

29-35 years old

34

gender differences in DID

3-9x more diagnosable in women than men

35

what are associated features with DID

1) self-harm
2) suicidal/aggressive behaviour
3) childhood trauma
4) family history
5) high hypnotic susceptibility

36

trauma model

dissociative disorders are a result of severe childhood trauma, including sexual, physical and emotional abuse accompanied by personality traits that predispose the individual to employ dissociation as a defence mechanism or coping strategy

37

socio-cognitive model

multiple personality is a form of role-playing in which individuals come to construe themselves as possessing multiple selves and then begin to act in ways consistent with their own or their therapist's conception of the disorder

38

iatrogenic condition

caused by treatment

39

Pseudogenic theory

occurs without any therapy intervention and is the stimulation of symptoms for secondary gain such as financial benefits or legal benefits

40

Psychotherapy steps for DID

1) build rapport
2) coping skills
3) reintegration of personalities

41

hypnosis for DID

popular - to contact alters and to uncover memories of traumatic childhood abuse - criticized now because of retrieving memories and personalities

42

medication for DID

not useful in direct treatment of dissociative disorders - helpful in treating comorbid disorders such as depression and anxiety

43

somatic symptom and related disorders

group of disorders which are presented with physical symptoms along with significant psychological distress and functional impairment

44

Conversion disorder

loss of functioning in a part of their body that appears to be due to a neurological or other medical cause but without any underlying medical abnormalities ex. motor deficits, seizures

45

signs of conversion disorder

abnormal medical readings (ex. EEG), inconstancies over time, unusual symptom patters, symptoms inconsistent with physiology

46

glove anaesthesia

loss of all sensation throughout the hand

47

la belle indifference

nonchalant lack of concern about the nature and implications of one's symptoms

48

somatic symptom disorder

multiple recurrent somatic symptoms such as pain, fatigue, nausea, muscle weakness, numbness or indigestion which may or may not be due to a diagnosed medical illness or disease - also have distress or impairment

49

what do patients with somatic symptom disorder act like

worry excessively about healthy, devote excessive time and energy thinking about them - may restrict activities, avoid social events, take sick days a lot etc.

50

what do patients with somatic symptom disorder often display

excessive amount of sensitivity to relatively minor bodily symptoms ex. breathing

51

what is one of the most frequent bodily symptoms associated with somatic symptom disorder

pain

52

somatic symptom disorder with predominant pain

individual must have pain in one or more body sites that is sever enough to cause significant distress or to disrupt the individual's daily life, possibly leading to inability to work, attend school etc.

53

what do patients with somatic symptom disorder with predominant pain run the risk of

becoming dependent on prescription medications such as painkillers or tranquilizers or may develop complications due to overuse of over the counter treatments

54

illness anxiety disorder

patients think the may have a serious medical disease despite the fact that thorough medical examination reveals that there is nothing seriously wrong with them

55

difference between illness anxiety disorder and somatic symptom disorder

patients with illness anxiety disorder do not have any significant bodily symptoms and are primarily concerned with the idea that they are ill

56

how long must the preoccupation in illness anxiety disorder must last?

6 months - feared illness may change

57

Factitious Disorder

fake or generate the symptoms of illness or injury to gain medical attention

58

motivation of factitious disorder

to receive sympathy, care and attention

59

factitious disorder imposed on another

individual falsifies illness in another person, most commonly one's own child

60

psychological factors of factitious disorder

cognitive factors, emotions, personality

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social factors of factitious disorder

early childhood adversity and abuse, reinforcement

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most common treatment of factitious disorder

CBT

63

emotional techniques for factitious disorder

coping strategies, emotion regulation skills

64

behavioral techniques for factitious disorder

behvaioral activation, reducing "sick role" behavior

65

body dysmorphic disorder (BDD)

excessive preoccupation with an imagined or exaggerated body disfigurement, sometimes to the point of a delusion

66

BBD vs. OCD

BDD obsessions focus on appearance, greater severity

67

BDD vs. eating disorder

BDD obsessions focus more than just weight and fat

68

BDD vs. psychotic disorders

BDD unlike schizophrenia, no other positive or negative symptoms; unlike delusional disorder - may have insight, engages in "checking behaviours"

69

what do traditional psychoanalytic explanations propose about disorders

conversion of the anxiety associated with unconscious conflicts and unacceptable sexual drives into somatic symptomatology and distress

70

biopsychosocial model

the way the factors interact leads to different disorders

71

when does BDD begin

begins in adolescence and tends to be a chronic disorder

72

gender differences for BDD

women higher rates comorbid eating disorders, men have higher rates of genital preoccupation, muscle dysphoira

73

is cosmetic surgery effective in BDD

no

74

How does CBT make use of cognitive restructuring techniques?

for modifying dysfunctional thoughts, interpretations, preoccupations relating to bodily symptoms and illness, as well as methods for helping patients to identify, understand, and regulate their emotions

75

perceptual retraining

focus on the "whole" aspect

76

ritual prevention

preventing compulsive behaviors